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Irritable Bowel Syndrome (Holistic)

About This Condition

IBS-not your typical tummy ache. Symptoms may include abdominal bloating and soreness, gas, alternating diarrhea and constipation, backaches, and fatigue. According to research or other evidence, the following self-care steps may be helpful.

Find the right fiber

Try different fiber sources, including high-fiber foods such as flaxseed, rye, brown rice, oatmeal, barley, and vegetables, as well as bulk-forming laxatives like psyllium husk and methylcellulose, to find the right balance of regularity without episodes of diarrhea

Avoid problem foods

Experiment with limiting dairy products and beans, as well as foods containing caffeine, fructose, or sorbitol, to see which restrictions may help reduce your symptoms

Try peppermint and caraway oils

Taking a coated herbal supplement providing 0.2 to 0.4 ml of peppermint oil, preferably combined with 50 mg of caraway oil, three times a day may reduce gas production, ease intestinal cramping, and soothe the intestinal tract

Explore food sensitivities

Work with a specialist to identify other foods that aggravate your condition

About

About This Condition

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that sometimes causes significant
discomfort even though it is not a serious health threat.

Symptoms

Typical symptoms include abdominal bloating and soreness, gas, and alternating diarrhea and constipation. People with IBS are more likely than others to have backaches, fatigue, and several other seemingly unrelated problems.

Holistic Options

IBS sufferers have increased sensitivity to rectal pain that has been linked to psychological factors.1 Stress is known to increase symptoms of IBS.2 Reducing stress or practicing stress management skills have been reported to be beneficial. In one trial, psychotherapy and relaxation combined with conventional treatment were more effective than conventional treatment alone in two-thirds of people with IBS.3Hypnosis for relaxation has dramatically and consistently relieved symptoms of IBS in some people.4, 5, 6

Traditional Chinese Medicine (TCM), which uses acupuncture and Chinese herbal therapies, has been reported to be helpful in the treatment of IBS,7 although no formal research has evaluated this claim.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation

Why

Find the right fiber

Try different fiber sources, including flaxseed, rye, brown rice, oatmeal, barley, and vegetables, to find the right balance of regularity without episodes of diarrhea.

Limited research has suggested that fiber might help people with IBS.8, 9 However, most studies find that IBS sufferers do not benefit by adding wheat bran to their diets,10, 11, 12, 13 and some people feel worse as a result of wheat bran supplementation.14 The lack of positive response to wheat bran may result from a wheat sensitivity,15 which is one of the most common triggers for food sensitivity in people with IBS.16Rye, brown rice, oatmeal, barley, vegetables, and psyllium husk are good sources of fiber and are less likely to trigger food sensitivities than is wheat bran. Except for psyllium, little is known about the effects of these other fibers in people with IBS.

Avoid problem foods

Try replacing dairy products and foods containing fructose and sorbitol with alternative dairy and sweetened products to see which restrictions may help reduce your symptoms.

There is evidence that some people with IBS have greater trouble absorbing the sugars lactose (as found in milk), fructose (as found in high concentration in fruit juice and dried fruit), and sorbitol (as found in some dietetic candy) than do healthy people.17, 18 In those people, restricting intake of the sugars that they have difficulty absorbing frequently decreases the symptoms of IBS.
Fructose and lactose are among the list of foods that contain fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs). Other foods high in FODMAPs include wheat, legumes, and foods high in sorbitol. Consumption of a low-FODMAP diet has been found to improve IBS symptoms in a high proportion of cases.19

Explore food sensitivities

Work with a specialist to identify foods that aggravate your Condition.

Several trials report that food sensitivities occur in only a small percentage of people with IBS.20, 21, 22 However, a leading researcher in the field claims at least 3.5 ounces of the offending food need to be consumed at frequent intervals to provoke IBS symptoms,23 and the amount of test foods used in these studies was generally less than this amount. Therefore, inadequate quantities of food may have affected the outcomes of these trials. Other trials have reported that most IBS sufferers have food sensitivities, and that gas production and IBS symptoms diminish when the offending foods are discovered and avoided.24, 25, 26, 27 Some researchers report that problem foods need to be eaten at every meal for at least two days to evaluate the potential of food sensitivity.28

Researchers have found that standard blood tests used to evaluate allergies may not uncover food sensitivities associated with IBS, because IBS food sensitivities may not be true allergies.29, 30 The only practical way to evaluate which foods might trigger IBS symptoms is to avoid the foods and then reintroduce them. Such a procedure requires the guidance of a healthcare practitioner. Attempts to find and avoid problem foods without professional help may fail and may aggravate symptoms.

Supplements

Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

The combination of 90 mg of peppermint oil plus 50 mg of caraway oil in enteric-coated capsules taken three times per day led to significant reduction in IBS symptoms in a double-blind trial.31 In a similar trial, capsules that were not enteric-coated were as effective as enteric-coated capsules.32 The same combination has compared favorably to the drug cisapride (Propulsid) in reducing symptoms of IBS.33 The purpose of enteric coating is to protect peppermint oil while it is passing through the acid environment of the stomach.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.34

3 Stars

Lactase (Lactose Intolerance)

6,000 to 9,000 IU tablets chewed with a meal containing lactose, or add 1,000 IU in liquid form to 8 ounces of milk

Lactase enzymes taken prior to consuming milk or dairy products may help ease IBS symptoms.

Double-blind research has shown that avoidance of lactose (present in milk and some other dairy products) by people with IBS who are also lactose intolerant will relieve IBS symptoms.35 Alternatively, lactase enzyme may be used prior to consuming milk. Several different lactase products are commercially available and the amount needed depends on the specific preparation being used.

In several double-blind trials, probiotic products have been found to relieve symptoms of IBS. Preparations that have been found to be effective include 1) a combination of Lactobacillus rhamnosus GG, L. rhamnosus Lc705, Propionibacterium freudenreichii ssp. shermanii JS and Bifidobacterium animalis ssp. lactis Bb12;36 2) Lactobacillus GG;37 3) a combination of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07;38 and 4) a product known as VSL#339

3 Stars

Psyllium

3.25 grams taken three times per day

Some people with IBS may benefit from bulk-forming laxatives. Psyllium has helped regulate normal bowel activity and improved symptoms in some people with IBS.

Some people with IBS may benefit from bulk-forming laxatives. Psyllium seeds (3.25 grams taken three times per day) have helped regulate normal bowel activity in some people with IBS.40 Psyllium has improved IBS symptoms in double-blind trials.41, 42

2 Stars

Melatonin

Take under medical supervision: 3 mg daily at bedtime

Melatonin helps regulate gastrointestinal function and sensation. In one trial, people with irritable bowel syndrome who took melatonin experienced significantly less severe abdominal pain.

Melatonin plays a role in the regulation of gastrointestinal function and sensation. In a double-blind trial, people with irritable bowel syndrome and associated sleep disturbances received 3 mg of melatonin or a placebo at bedtime for two weeks. Compared with the placebo, melatonin significantly decreased the severity of abdominal pain, although it did not affect bloating, stool frequency, or sleep patterns.43 Melatonin was also effective in another double-blind trial.44

2 Stars

Peppermint

0.2 to 0.4 ml in enteric-coated capsules, three times per day

Peppermint oil reduces gas production, eases intestinal cramping, and soothes irritation. It has been reported to help relieve IBS symptoms in two analyses of controlled trials.

In the intestinal tract, peppermint oil reduces gas production, eases intestinal cramping, and soothes irritation.45 Peppermint oil has been reported to help relieve symptoms of IBS in two analyses of controlled trials.46, 47 Evidence supporting the use of peppermint oil has come from double-blind trials that typically have used enteric-coated capsules that supply 0.2-0.4 ml of peppermint oil taken two to three times per day.48, 49, 50, 51, 52 Some trials have found peppermint oil ineffective.53, 54 However, a pooled analysis (meta-analysis) of 9 randomized controlled trials (with a total of 726 patients) found that enteric-coated peppermint oil capsules are a safe and effective treatment for IBS.55

The combination of 90 mg of peppermint oil plus 50 mg of caraway oil in enteric-coated capsules taken three times per day led to significant reduction in IBS symptoms in a double-blind trial.56 In a similar trial, capsules that were not enteric-coated were as effective as enteric-coated capsules.57 The same combination has compared favorably to the drug cisapride (Propulsid) in reducing symptoms of IBS.58 The purpose of enteric coating is to protect peppermint oil while it is passing through the acid environment of the stomach.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.59

2 Stars

Peppermint, Caraway Seeds, Fennel Seeds, and Wormwood

Refer to label instructions

A combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in one trial.

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.60

1 Star

Artichoke

Refer to label instructions

In a preliminary study of people with irritable bowel syndrome who took an artichoke leaf extract daily for two months, 26% reported an improvement in symptoms.

In a preliminary study of people with irritable bowel syndrome who took an artichoke leaf extract daily for two months, 26% reported an improvement in symptoms.61 Because no placebo group was used in this study and because irritable bowel syndrome has a high rate of response to placebo, additional research is needed to confirm this report. The amount of artichoke leaf used in the study was 320 or 640 mg per day of a 1:5 standardized extract.

1 Star

Chamomile

Refer to label instructions

Chamomile's essential oils may ease intestinal cramping and irritation. The herb is sometimes used by herbalists to relieve alternating bouts of diarrhea and constipation.

Chamomile's essential oils have eased intestinal cramping and irritation in animals.62 Chamomile is sometimes used by herbalists to relieve alternating bouts of diarrhea and constipation, though research has yet to investigate these effects. This herb is typically taken three times per day, between meals, in a tea form by dissolving 2-3 grams of powdered chamomile or by adding 3-5 ml of herbal extract tincture to hot water.

1 Star

Evening Primrose Oil (Premenstrual Syndrome)

Refer to label instructions

In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking evening primrose oil.

In one trial, women with IBS who experienced worsening symptoms before and during their menstrual period were helped by taking enough evening primrose oil (EPO) to provide 360-400 mg of gamma linolenic acid (GLA) per day.63 In that trial more than half reported improvement with EPO, but none was helped in the placebo group. The effects of EPO in other groups of IBS sufferers have not been explored.

1 Star

Fiber

Refer to label instructions

Supplementing with fiber may help you find the right balance of regularity without episodes of diarrhea.

Limited research has suggested that fiber might help people with IBS.64, 65 However, most studies find that IBS sufferers do not benefit by adding wheat bran to their diets,66, 67, 68, 69 and some people feel worse as a result of wheat bran supplementation.70 The lack of positive response to wheat bran may result from a wheat sensitivity,71 which is one of the most common triggers for food sensitivity in people with IBS.72 Rye, brown rice, oatmeal, barley, vegetables, and psyllium husks are good sources of fiber and are less likely to trigger food sensitivities than is wheat bran. Except for psyllium, little is known about the effect of these other fibers in people with IBS.

1 Star

Grapefruit Seed Extract

Refer to label instructions

In one study, grapefruit seed extract improved IBS symptoms in 20% of people taking the liquid, while all of the patients taking capsules noted definite improvement of constipation, flatulence, abdominal discomfort, and night rest.

A preliminary trial investigated the effectiveness of grapefruit seed extract in people with eczema and symptoms of IBS.73 Participants received either 2 drops of a 0.5% oral solution of grapefruit seed extract twice daily or 150 mg of encapsulated grapefruit seed extract three times daily. After a month, IBS symptoms had improved in 20% of those taking the liquid, while all of the patients taking capsules noted definite improvement of constipation, flatulence, abdominal discomfort, and night rest. These results need confirmation in double-blind trials.

1 Star

Wormwood, Ginger, Bupleurum, Schisandra, Dan Shen, and Other Extracts

Take a Chinese herbal formula containing wormwood under the guidance of a qualified practitioner

Whole peppermint leaf is often used either alone or in combination with other herbs to treat abdominal discomfort and mild cramping that accompany IBS. The combination of peppermint, caraway seeds, fennel seeds, and wormwood was reported to be an effective treatment for upper abdominal complaints in a double-blind trial.74

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2016.

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